No abstract

To evaluate the effects of pulse high-volume hemofiltration (PHVHF) on severe acute pancreatitis (SAP) with multiple organ dysfunction syndrome (MODS). Thirty patients were divided into two groups: PHVHF group and continuous venovenous hemofiltration (CVVH) group. They were evaluated in terms of clinical symptoms, acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, simplified acute physiology (SAPS) II score and biochemical changes. The levels of IL-6, IL-10 and TNF-α in plasma were assessed by ELISA before and after treatment. The doses of dopamine used in shock patients were also analyzed. In the two groups, symptoms were markedly improved after treatment. Body temperature (BT), breath rate (BR), heart rate (HR), APACHE II score, SOFA score, SAPS II score, serum amylase, white blood cell count and C-reactive protein were decreased after hemofiltration (P < 0.05). The PHVHF group was superior to the CVVH group, especially in APACHE II score, CRP (P < 0.01), HR, temperature, SOFA score and SAPS II score (P < 0.05). The doses of dopamine for shock patients were also decreased in the two groups (P < 0.05), with more reduction in the PHVHF group than the CVVH group (P < 0.05). The levels of IL-6, IL-10 and TNF-α decreased (P < 0.05) in the PHVHF group more significantly than the CVVH group (P < 0.01). PHVHF appears to be superior to CVVH in the treatment of SAP with MODS.

Sepsis can cause septic shock, multiple organ dysfunction and even death. The combination of different blood purification would be the certain trend in the treatment of sepsis. This study was to evaluate the clinical effects of hemoperfusion (HP) combined with pulse high volume hemofiltration (PHVHF) on septic shock. Thirty cases were involved in this study and were randomly divided into two groups: HP and PHVHF group (n = 15) and CVVH (continuous veno-venous hemofiltration) group (n = 15). Acute physiology and chronic health evaluation (APACHE) II scores, sequential organ failure assessment (SOFA) scores as well as biochemical changes were measured before and after the treatment. The levels of IL-6, IL-10, and TNF-α in plasma were assessed by ELISA before and after treatment for 2 and 24 h. The norepinephrine doses were also analyzed. The 28-day mortalities in both groups were also compared. In both groups, body temperature (BT), respiratory rate (RR), white blood cells (WBC), C-reactive protein (CRP), Procalcitonin (PCT), lactic acid, serum creatinine, APACHE II scores and SOFA scores decreased after hemofiltration ( P < .05). The HP&PHVHF group was superior to the CVVH group in CRP, APACHE II score ( P < .01), and heart rate (HR), WBC, PCT, SOFA ( P < .05). The doses of norepinephrine were also decreased after treatment ( P < .01), with more reduction in the HP&PHVHF group ( P < .05). After 24 h of treatment, the levels of IL-6, IL-10, and TNF-α decreased in both groups ( P < .05), and the decrease was more significant in HP&PHVHF group ( P < .05). In combined group, after 2 h of hemoperfison, there was a significant reduction in these inflammatory factors ( P < .01). Combined therapy group's mortality was 26.7%, while CVVH group's was 40%. HP combined with PHVHF has a significant effect on septic shock and can be an important therapy for septic shock.